Thermage Problems

What types of problems ARE there with Thermage? Thermage does two things! One, it builds new collagen in everyone and we know this from excellent before and after studies that included a biopsy before and after Thermage on each patient.  And two, it gives a nice, but subtle lifting and tightening to many patients (about 90%), IF (and this is important) the patient is selected correctly!  Herein lies the main problem.

You all know that Thermage is the skin tightening procedure that uses radio-frequency to stimulate collagen growth, which then tightens the skin.  Thermage is done on the forehead, cheeks, jaw line and neck to reduce sagging skin or skin laxity.  For lots of information on Thermage skin tightening, see my articles on Thermage and Eyelid Thermage.

So here’s what you need to know to have a good experience with Thermage and avoid problems and complications:

  • The best results are with patients about 25-55 years old who want to maintain their collagen and get a little skin tightening.
  • It also works well, in my opinion, for patients who are older (over 55ish) for jawline maintenance with 1-2 treatments a year. A visible lift is not the goal here.
  • It does NOT work well on true jowls, very thin sun damaged skin, lots of sagging under the chin and wrinkles/sagging on the neck itself (unless it’s mild).
  • Make sure the laser center that is doing your treatment uses the 900 pulse tip for the full face and the more current ‘vector method.’
  • Ideally, for full face the treatment is wrapped under the chin and doesn’t require you to purchase the neck also for just the under chin area.
  • The treatment should take 1-2 hours depending on the nurse operating the system.  You want the full 900 pulses if possible.
  • This treatment shouldn’t be very uncomfortable if the center has the updated (several years ago) Thermage system/tips. That system has wonderful sapphire cooled tips that make the treatment quite comfortable.  The older system and tips were very uncomfortable.  Generally, no anesthesia or pain killers other than Tylenol should be needed.
  • You really do not need to worry about divits/dents if your doctor follows the current protocols and has the updated system. These problems occurred years ago mostly when a handful of doctors would ‘turn up’ the old system way past the recommended energies.
  • Have realistic expectations! This is not a facelift and it’s really not for anyone who has a true jowl. You will be very happy with it if you expect an extra glow (from that extra collagen), a nice but subtle texture improvement, and a small lifting effect. It can be quite wonderful at helping to maintain the jawline doing 1-2 treatments a year over a period of years.

Enjoy Your Thermage!!

Read our full Guide to Thermage
Read our full Guide to Eyelid Thermage
Watch Dr Irwin demonstrate a Thermage Treatment
Watch Dr Irwin discuss Thermage and Fraxel Lasers For The Treatment of Sagging Skin 

See Dr. Irwin’s expert answers to other reader’s questions on Thermage Problems:
Does this sound like a good Thermage plan in London?
Can Thermage make melasma worse?
Is it OK to have Thermage with a metal plate in my shoulder?